Ambulanspersonals upplevelser av ambulansuppdrag där de tillsammans med räddningstjänsten vårdar patienter drabbade av hjärtstopp utanför sjukhus : En kvalitativ intervjustudie utförd i en stad i västra Sverige

Årligen drabbas ca 10000 personer av hjärtstopp utanför sjukhus. I de fall ambulansen har en lång framkörning finns det på flera håll ett samarbetsavtal skrivet med lokal räddningstjänst som innebär att en s.k. IVPA-styrka, "I Väntan På Ambulans", larmas till patienten och påbörjar HLR. Syftet med studien är att få reda på hur ambulanspersonalen i ett valt område ser på samarbetet med IVPA i samband med hjärtstopp prehospitalt. Åtta kvalitativa intervjuer av ambulanssjuksköterskor genomfördes. Dessa analyserades med induktiv forskningsansats på deskriptiv nivå. Detta resulterade i sju huvudkategorier; Tilltro till tidsvinst för att gagna liv, Bemannat för att klara uppgiften, HLR-koncept delvis uppfyllt, IVPA överlåter och ambulans tar över ansvar, Behov av riktlinjer för kommunikation, IVPA förbättrar logistik och Behov av ambulanspersonal i arbetsledning. Resultatet visar att IVPA-personalen har goda ambitioner att delta i arbetet, informanterna upplever en tidsvinst med IVPA-insatsen som kan vara avgörande för patienten. IVPA-enheten är välorganiserad och detta främjar det livräddande arbetet med patienten. Det arbete som IVPA-personalen utför är bra men med vissa tekniska brister, som t.ex. hantering av luftväg. Författarna efterfrågar gemensamma utbildningstillfällen där ambulanspersonal och räddningstjänst får tillfälle till samövning, för att förbättra vården ytterligare. De nyckelord som använts är IVPA, prehospitalt hjärtstopp, OHCA (Out of Hospital Cardiac Arrest), tvärprofessionellt samarbete och samverkan.Program: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvår

Simulation in Virtual World to Promote Communication

Introduction Communication between ambulance professionals and patients is essential for understanding the patient's lifeworld (Wireklint Sundström & Dahlberg 2010). Simultaneously, communication is challenging to teach and learn within the framework of specific courses. However, simulation in virtual worlds can support the development of new skills such as communication (Combs, Sokolowski & Banks 2016).   Aim The aim of this work was to design a simulation-based platform for communication training among ambulance nurse students (ANS).   Methods A qualitative action research approach was used (Coghlan & Casey 2001). Second Life® (SL) was selected since it was an existing virtual world. SL is a web-based flexible three-dimensional platform that allows customization. Interaction and communication with other virtual people can be done through avatars in real time (Hodge, Collins & Giordano 2011). Three ANS and five teachers participated, none of the participants had prior experience of SL. Observations and interviews were used as data and analysed using thematic analysis.   Results The participants’ experiences generated three themes:   Understanding the virtual world It was easy to interact and communicate with other virtual people. However, it took time to feel comfortable to navigate in SL.   Technological challenges One challenge was related to audio-visual problems e.g. not compatible headset, interfering echoes and that the image was distorted at times, which made it difficult to act and move the avatar. Another challenge was associated with the 3D modelling e.g. the capability to use of coordinates, positioning, object dimensioning and the fact that accidental deletions could not be restored. A third challenges that influenced the communication was the difficulty of visualizing clinically relevant care measures such as diagnostic examinations or drug treatment. Finally, there was a challenge to customize the avatars to look like ambulance professionals or a severely ill patient.   Learning through avatars Learning through avatars requires that the participants take responsibility for delivering a convincing performance.  Immersion was limited since actions do not take place from a first-person viewpoint. There is a need that the scenario is based on realistic conditions e.g. interiors, equipment, clothing, avatar appearance and behaviour.   Conclusion The present system is not suitable for training of medical assessment. Teachers who are considering using virtual worlds in the training for future ambulance professionals should note that an appropriate design is crucial for how the simulation is experienced.

Simulation in Virtual World to Promote Communication

Introduction Communication between ambulance professionals and patients is essential for understanding the patient's lifeworld (Wireklint Sundström & Dahlberg 2010). Simultaneously, communication is challenging to teach and learn within the framework of specific courses. However, simulation in virtual worlds can support the development of new skills such as communication (Combs, Sokolowski & Banks 2016).   Aim The aim of this work was to design a simulation-based platform for communication training among ambulance nurse students (ANS).   Methods A qualitative action research approach was used (Coghlan & Casey 2001). Second Life® (SL) was selected since it was an existing virtual world. SL is a web-based flexible three-dimensional platform that allows customization. Interaction and communication with other virtual people can be done through avatars in real time (Hodge, Collins & Giordano 2011). Three ANS and five teachers participated, none of the participants had prior experience of SL. Observations and interviews were used as data and analysed using thematic analysis.   Results The participants’ experiences generated three themes:   Understanding the virtual world It was easy to interact and communicate with other virtual people. However, it took time to feel comfortable to navigate in SL.   Technological challenges One challenge was related to audio-visual problems e.g. not compatible headset, interfering echoes and that the image was distorted at times, which made it difficult to act and move the avatar. Another challenge was associated with the 3D modelling e.g. the capability to use of coordinates, positioning, object dimensioning and the fact that accidental deletions could not be restored. A third challenges that influenced the communication was the difficulty of visualizing clinically relevant care measures such as diagnostic examinations or drug treatment. Finally, there was a challenge to customize the avatars to look like ambulance professionals or a severely ill patient.   Learning through avatars Learning through avatars requires that the participants take responsibility for delivering a convincing performance.  Immersion was limited since actions do not take place from a first-person viewpoint. There is a need that the scenario is based on realistic conditions e.g. interiors, equipment, clothing, avatar appearance and behaviour.   Conclusion The present system is not suitable for training of medical assessment. Teachers who are considering using virtual worlds in the training for future ambulance professionals should note that an appropriate design is crucial for how the simulation is experienced.

Educational intervention in triage with the Swedish triage scale RETTS©, with focus on specialist nurse students in ambulance and emergency care – A cross-sectional study

AimTo determine the reliability of application of the RETTS© triage scale after an educational intervention using paper-based scenarios in emergency care education.BackgroundKnowledge about and education in triage are important factors in triagescale implementation. Presenting students with a large number of triage scenarios is a common part of triage education.MethodsIn this prospective cross-sectional study at two universities students undergoing education in emergency care used RETTS© to assess triage level in 46 paper-based scenarios.Results57 students in the study made 2590 final triage decisions. Fleiss Kappa for final triage was 0.411 which is in the lower range of moderate agreement. In 25 of 46 (53.4%) scenarios, final triage levels did not agree about whether the case was stable or unstable.Conclusion/ImplicationsApplication of the RETTS© triage scale after an educational intervention with paper-based simulation in emergency care education resulted in moderate agreement about the final levels of triage